YOU’RE INVITED! GoodHormoneHealth Webinar on Lifestyle Medicine for Patients with Endocrine Problems With Eddie Ramirez, MDDr. Theodore Friedman (The Wiz) will be joined by Eddie Ramirez, MD
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Year: 2022
12 Days of Cortisol Christmas Event
“We invite you to join us for our opening 12 Days of Cortisol Christmas event, “Overcoming Fatophobia” with Dr. Karen Thames.
Dr. Karen, a licensed clinical psychologist and founder of the EPIC Foundation, has battled Cushing’s disease and is now adrenal insufficient as a result. She has faced the battle of weight stigma both professionally and personally. In this interview, she bravely shares her story and advice on how to overcome #fatphobia in #chronicillness.
Adrenal Alternative’s 12 days of Cortisol Christmas is an event where we give back to the adrenal community during the Holiday Season.
Throughout the 12 days, we will be giving away adrenal awareness merch, hosting interviews with patients and professionals, and sharing helpful resources.
Even though patients must fight the war that is #adrenalinsufficiency, we want to let you know that you are supported by an army of adrenal warriors and you are not alone.”
~Adrenal Alternatives Foundation
Basics: Testing: Prolactin
A prolactin (PRL) test measures how much of a hormone called prolactin you have in your blood. The hormone is made in your pituitary gland, which is located just below your brain.
When women are pregnant or have just given birth, their prolactin levels increase so they can make breast milk. But it’s possible to have high prolactin levels if you’re not pregnant, and even if you’re a man.
Your doctor may order a prolactin test when you report having the following symptoms:
For women
- Irregular or no periods
- Infertility
- Breast milk discharge when you’re not pregnant or nursing
- Tenderness in your breast
- Menopausal symptoms such as hot flashes and vaginal dryness
For men
- Decreased sex drive
- Difficulty in getting an erection
- Breast tenderness or enlargement
- Breast milk production (very rare)
For both
Causes of Abnormal Prolactin Levels
Normally, men and nonpregnant women have just small traces of prolactin in their blood. When you have high levels, this could be caused by:
- Prolactinoma (a benign tumor in your pituitary gland that produces too much prolactin)
- Diseases affecting the hypothalamus(the part of the brain that controls the pituitary gland)
- Anorexia(an eating disorder)
- Drugs that are used to treat depression, psychosis, and high blood pressure
- Chest injury or irritation (for example, scars, shingles, or even a bra that’s too tight)
Also, kidney disease, liver failure, and polycystic ovarian syndrome (a hormone imbalance that affects ovaries) all can affect the body’s ability to remove prolactin.
How the Test Is Done
You don’t need to make any special preparations for a prolactin test. You will get a blood sample taken at a lab or a hospital. A lab worker will insert a needle into a vein in your arm to take out a small amount of blood.
Some people feel just a little sting. Others might feel moderate pain and see slight bruising afterwards.
After a few days, you’ll get the results of your prolactin test in the form of a number.
The normal range for prolactin in your blood are:
- Males: 2 to 18 nanograms per milliliter (ng/mL)
- Nonpregnant females: 2 to 29 ng/mL
- Pregnant females: 10 to 209 ng/mL
If Your Prolactin Levels Are High
If your value falls outside the normal range, this doesn’t automatically mean you have a problem. Sometimes the levels can be higher if you’ve eaten or were under a lot of stress when you got your blood test.
Also, what’s considered a normal range may be different depending on which lab your doctor uses.
You’ll lie inside a magnetic tube as the MRI device uses radio waves to put together a detailed image of your brain. It will show whether there’s a mass near your pituitary gland and, if so, how big it is.
If Your Levels Are Low
If your prolactin levels are below the normal range, this could mean your pituitary gland isn’t working at full steam. That’s known as hypopituitarism. Lower levels of prolactin usually do not need medical treatment.
Certain drugs can cause low levels of prolactin. They include:
- Dopamine (Intropin), which is given to people in shock
- Levodopa(for Parkinson’s disease)
- Ergot alkaloid derivatives(for severe headaches)
Treatment
Not all cases of high prolactin levels need to be treated.
Your treatment will depend on the diagnosis. If it turns out to be a small prolactinoma or a cause can’t be found, your doctor may recommend no treatment at all.
In some cases, your doctor may prescribe medicine to lower prolactin levels. If you have a prolactinoma, the goal is to use medicine to reduce the size of the tumor and lower the amount of prolactin.
Clinical Trial: SPI-62 as a Treatment for Adrenocorticotropic Hormone-dependent Cushing’s Syndrome (RESCUE)
Brief Summary:
This is a randomized, placebo-controlled, crossover study of SPI-62 in subjects with ACTH-dependent Cushing’s syndrome. Subjects will receive each of the following 2 treatments for 12 weeks: SPI-62 and matching placebo
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Cushing’s Syndrome ICushing Disease Due to Increased ACTH Secretion Cortisol ExcessCortisol; Hypersecretion Cortisol Overproduction Ectopic ACTH Secretion | Drug: SPI-62 Drug: Placebo | Phase 2 |
This is a multicenter, randomized, placebo-controlled, Phase 2 study to evaluate the pharmacologic effect, efficacy, and safety of SPI-62 in subjects with ACTH-dependent Cushing’s syndrome. Each subject who provides consent and meets all inclusion and exclusion criteria will participate in 3 periods: a 28-day screening period (Days -35 to -8), a 7-day baseline period (Days -7 to -1), and a 24-week treatment period (Day 1 of Week 1 to Day 168 ± 3 days of Week 24). Up to 26 subjects will be enrolled with the aim that 18 subjects with Cushing’s disease will complete the study. Subjects will receive each of the following 2 treatments for 12 weeks: SPI-62 and matching placebo.
| Study Type : | Interventional (Clinical Trial) |
| Estimated Enrollment : | 26 participants |
| Allocation: | Randomized |
| Intervention Model: | Crossover Assignment |
| Intervention Model Description: | Staggered parallel crossover |
| Masking: | Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) |
| Primary Purpose: | Treatment |
| Official Title: | SPI-62 as a Treatment for Adrenocorticotropic Hormone-dependent Cushing’s Syndrome |
| Actual Study Start Date : | March 1, 2022 |
| Estimated Primary Completion Date : | March 15, 2023 |
| Estimated Study Completion Date : | August 15, 2023 |
More info at https://clinicaltrials.gov/ct2/show/record/NCT05307328
Basics: Diagnostic Procedures in Suspected Adrenocortical Carcinoma
Patients with suspected adrenocortical carcinoma (ACC) may also undergo additional tests to identify excess sex steroids and steroid precursors, mineralocorticoids and glucocorticoids.
Table 2 provides a summary of the tests recommended by the European Society of Endocrinology in collaboration with the European Network for the Study of Adrenal Tumors in patients with suspected ACC.10
Table 2. Diagnostic work-up in patients with suspected or proven adrenocortical carcinoma. Reproduced from Fassnacht et al., 2018,10 with permission under a Creative Commons Attribution 4.0 International License.
ACTH: adrenocorticotropic hormone; DHEA-S: dehydroepiandrosterone sulphate; CT: computed tomography; FDG-PET: 18F-fluorodeoxyglucose positron emission tomography; MRI: magnetic resonance imaging.
- Click image to enlarge
Basics: Pseudo-Cushing’s syndrome
Pseudo-Cushing’s syndrome is when symptoms are similar to those of Cushing’s syndrome, but further tests show that the syndrome is not present.
Common causes include consuming too much alcohol, obesity, persistently high blood glucose levels, pregnancy, and depression.
Basics: What Causes Abnormal Cortisol Levels?
Cortisol isn’t bad; you need it to help regulate your responses to life. Regulation involves a very complex interplay of feedback loops between the hypothalamus, pituitary gland, and adrenal glands, says Dr. Singh.
“In general, cortisol levels tend to peak in the late morning and gradually decline throughout the day,” he explains. “When a stressful event occurs, the increased cortisol will work alongside our ‘fight or flight’ mechanisms to either upregulate or downregulate bodily functions. [Affected systems include] the central nervous system, cardiovascular system, gastrointestinal system, or immune system.”
In addition to normal processes that trigger or suppress cortisol release, levels can also be affected by different medical conditions, Dr. Singh says. For example, if someone has abnormally high levels of cortisol, this is called Cushing’s syndrome, which is typically caused by a tumor affecting any of the glands that take part in the process of cortisol production.
When people suffer from abnormally low levels of cortisol, it’s called Addison’s disease. It generally occurs due to adrenal gland dysfunction, but could also be the result of abnormal functioning of any of the other glands in the cortisol production process.
Finally, if you use corticosteroid medications such as prednisone or dexamethasone, prolonged use will result in excessive cortisol production, Dr. Singh says.
“If the medication is not adequately tapered down when discontinued, the body’s ability to create cortisol can become permanently impaired,” he says.
From https://www.yahoo.com/lifestyle/manage-pesky-stress-hormone-cortisol-184900397.html
Webinar: Best Practices for the Management of Individuals with Cushing’s Disease
First of its kind CME webinar on #CushingsDisease for #endocrinologists and other clinicians treating patients with #Cushings
Aug. 2, 2022 / PRZen / HAZLET, N.J. — In this CME Webinar, #endocrinology experts in the management of #CushingsDisease will describe best practices for the diagnosis and treatment to improve long-term outcomes for patients..
SPEAKERS:
Maria Fleseriu, MD
Professor of Medicine and Neurological Surgery
Oregon Health & Science University
Irina Bancos, MD
Associate Professor of Medicine
Mayo Clinic
Voxmedia LLC gratefully acknowledges the educational donation provided by Recordati Rare Diseases, Inc.
This educational activity is intended for #endocrinologists and other clinicians who manage patients with cushing’s disease.
Voxmedia LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Voxmedia LLC designates this webinar activity for a maximum of 1.00 AMA PRA Category Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurse practitioners may participate in this educational activity and earn a certificate of completion as AANP accepts AMA PRA Category 1 Credits™ through its reciprocity agreements.
The National Commission on Certification of Physician Assistants accepts AMA PRA Category 1 Credits™ from organizations accredited by the ACCME.
For additional CME activities and online cme courses visit CMEPlanet. #endocrinologist #EndocrinePractice #Cushings #Cushing #ThinkCushings #CushingsAwarenessDay #pituitary #TheEndoSociety #ENDO2022
Follow the full story here: https://przen.com/pr/33469903
Human Growth Hormone Study
Research opportunity for Human Growth Hormone Deficiency caregivers of adolescent patients. This is a 75 min web-assisted phone interview, and the compensation is $125.
Please sign up at the link below to receive an email invite to the survey.
🦓 Day 30, Cushing’s Awareness Challenge 2022
Today is the final day of the Cushing’s Awareness Challenge and I wanted to leave you with this word of advice…
To that end, I’m saving some of what I know for future blog posts, maybe even another Cushing’s Awareness Challenge next year. Possibly this has become a tradition.
I am amazed at how well this Challenge went this year, giving that we’re all Cushies who are dealing with so much. I hope that some folks outside the Cushing’s community read these posts and learned a little more about us and what we go through.
So, tomorrow, I’ll go back to posting the regular Cushing’s stuff on this blog – after all, it does have Cushing’s in its name!
I am trying to get away from always reading, writing, breathing Cushing’s, and trying to celebrate the good things in my life, not just the testing, the surgery, the endless doctors.
If you’re interested, I have other blogs about traveling, friends, fun stuff and trying to live a good life, finally. Those are listed in the right sidebar of this blog, past the Categories and before the Tags.
Meanwhile…
Choose wisely…
